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Updated: Apr 18, 2026
Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Mycoplasma pneumoniae detection causes excess antibiotic use in Norwegian general practice: a retrospective
Mats Foshaug1, Maria Vandbakk-Rüther2, Dagfinn Skaare3
1Stokke Centre of Primary Care, Stokke, Norway.
Background:
The 2011 Mycoplasma pneumoniae epidemic in Norway resulted in many GP consultations and significantly increased the prescription of macrolide antibiotics.
Aim:
To investigate the signs, symptoms, course, and prescription patterns of antibiotics in patients positive for M. pneumoniae compared with patients negative for M. pneumoniae.
Design And Setting:
A retrospective case-control study using questionnaires collected from GPs in a county in Norway. A total of 212 M. pneumoniae positive and 202 control patients were included.
Method:
Descriptive statistics and logistic regression analyses were performed on the reported findings.
Results:
Forty-eight per cent of patients positive for M. pneumoniae received an antibiotic at first consultation. Another 45% in the same group received antibiotics after the polymerase chain reaction (PCR) result was known, although these patients were not clinically different from all other patients not receiving an antibiotic at first consultation. Logistic regression analysis to evaluate independent predictors for prescription of antibiotics at first consultation showed that the following factors were significantly associated: elevated C-reactive protein (CRP) level, temperature >38.0°C, pathological findings on pulmonary auscultation, and impaired general condition. Elevated CRP level, younger age, temperature >38.0°C, short duration of symptoms, and absence of rhinitis were found to be positive predictors for M. pneumoniae infection.
Conclusion:
A positive PCR test for M. pneumoniae tends to trigger an antibiotic prescription, irrespective of the severity of the patient's condition at first consultation. New guidelines for treatment and possibly PCR testing should be established.
Insights
A positive Mycoplasma pneumoniae (MP) PCR test often leads to antibiotic prescriptions, even when clinical severity doesn't warrant it. New guidelines for MP testing and treatment are recommended.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- General Practice
Background:
- The 2011 Mycoplasma pneumoniae epidemic in Norway led to increased GP visits and macrolide antibiotic prescriptions.
- Understanding M. pneumoniae infection patterns is crucial for appropriate antibiotic stewardship.
Purpose of the Study:
- To compare clinical signs, symptoms, and antibiotic prescribing patterns in M. pneumoniae-positive versus M. pneumoniae-negative patients.
- To identify predictors of M. pneumoniae infection and antibiotic prescription.
Main Methods:
- Retrospective case-control study utilizing GP-collected questionnaires.
- Included 212 M. pneumoniae positive patients and 202 controls.
- Statistical analyses included descriptive statistics and logistic regression.
Main Results:
- 48% of M. pneumoniae-positive patients received antibiotics at first consultation; 45% received them after PCR results.
- Antibiotic prescription post-PCR occurred irrespective of clinical differences.
- Predictors for M. pneumoniae included elevated CRP, fever >38.0°C, abnormal lung auscultation, and impaired general condition.
Conclusions:
- Positive M. pneumoniae PCR results frequently trigger antibiotic prescriptions, independent of clinical severity.
- Current antibiotic prescribing practices for M. pneumoniae may require revision.
- Development of new guidelines for M. pneumoniae treatment and PCR testing is suggested.
